2/20/2019

When filling out or attesting in the CAQH application, providers must verify that the information is correct. To ensure that this information is correct, the provider or office staff must review the following information and update if applicable:

  • Current location information (new addresses, additional practice locations, phone and fax number updates)
    • If the provider is no longer practicing at a location, a termination date is required.
  • ​Malpractice insurance expirations
  • Hospital privileges
  • Current contacts should be listed, including phone number and e-mail addresses.
  • Authorization Release Form check list:
    • The form should include ALL of the following elements for it to be accepted:
      • Full name of the primary authorized contact and his or her contact information
      • Full name of the secondary authorized contact (if applicable) and his or her contact information
      • Printed name of the provider
      • Provider's CAQH ID number
      • Wet signature of the provider
      • Date of signature
    • Make sure that scanned release form is readable before loading it to ProView.